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Small cell lung cancer accounts for approximately one quarter of all lung cancers. This cancer differs from other types of lung cancer in that it tends to spread throughout the body very quickly through the blood and lymph vessels. Persons with

limited small cell lung cancer, meaning the cancer is confined to one area of the chest, are usually treated with radiation therapy and combination chemotherapy. Results from a new study published in the

Journal of Clinical Oncology suggest that the combination of etoposide, cisplatin and ifosfamide with concurrent use of a relatively new type of accelerated radiation therapy may improve treatment results for patients with limited small cell lung cancer.

Small cell lung cancer is characterized by the presence of cancer cells in the lung. The extent of disease is divided into three stages:

limited, the cancer is present only in one lung and surrounding lymph nodes,

extensive, cancer has spread to distant sites in the body, or

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recurrent, cancer has returned after treatment. The most common form of treatment for persons with limited small cell lung cancer is combination chemotherapy consisting of etoposide and cisplatin, and radiation therapy to the chest, with or without additional radiation therapy to the brain (to prevent cancer recurrence there). Since this is an aggressive cancer, research efforts are ongoing in an attempt to determine the most effective treatment strategies in order to prolong survival in these patients.

Researchers at the MD Anderson hospital recently evaluated the concurrent administration of a multi-drug combination of chemotherapy with radiation therapy in 67 patients with limited small cell lung cancer. The chemotherapy consisted of etoposide, ifosfamide and cisplatin. The type of radiation delivered was called accelerated hyperfractionated thoracic radiation therapy (AHTRT), which is a type of radiation therapy that is administered twice a day, at higher doses and for a shorter period of time compared to standard radiation therapy. Fifty percent of the patients in this study survived 2 years following treatment and 39% survived 3 years following treatment. Importantly, only 20% had a cancer recurrence in their lung or chest 2 years following treatment. However, a significant portion of patients suffered from radiation damage to the esophagus.

These results indicate that cisplatin, ifosfamide and etoposide combined with AHTRT resulted in similar survival times when compared to standard treatment. However, cancer recurrences in the lung and chest were significantly decreased compared to standard treatment. These physicians suggested that more time is needed to clearly reveal if increased survival time could be achieved with this new regimen. Persons who have limited small cell lung cancer may wish to talk with their physicians about the risks and benefits of participating in a clinical trial utilizing this strategy or other promising new treatment strategies. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy to use service provided by the National Cancer Institute ( and also provides personalized clinical trial searches on behalf of patients. (

Journal of Clinical Oncology, Vol 18, No 16, pp 2990-2995, 2000)

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